When a woman faces a breast cancer diagnosis, she needs to remember that she has choices on this journey. No woman should have to settle simply because “that’s the way it’s always been done.” This is especially true when it comes to preparing for a mastectomy.
At Bedford Breast Center in Beverly Hills, CA, we understand how a mastectomy is a life-changing event for a woman. Therefore, starting with the highest standards for outcomes, our breast cancer surgeons not only take into account the eradication of disease but the enhancement of aesthetics as well.
At our medical center, we are proud to offer patients beautiful, healthy breasts using innovative breast cancer treatments such as nipple-sparing mastectomy, one-stage breast reconstruction, and sensation-preserving mastectomy – allowing women to look and feel more like they did before surgery.
What Is Nipple-Sparing Mastectomy?
During a traditional mastectomy, surgeons remove the nipple and the dark skin around the nipple (the areola). Many women facing the prospect of mastectomy may experience feelings of loss and grief from these changes to their bodies. However, there may be options that will give women a better outcome than they first imagined, including a procedure that preserves the nipple to provide women with a more natural result.
Although the primary benefit of a nipple-sparing mastectomy (NSM) is the breasts’ aesthetic appearance post-surgery, the procedure can have a lasting psychological and emotional impact on the patient. A surgeon’s ability to preserve the breast and nipples helps achieve higher patient satisfaction and improved perceived general wellness than those who underwent a traditional mastectomy.
Benefits of Nipple-Sparing Mastectomy
Unlike traditional mastectomies, which leave large, horizontal scars across the breast area, surgeons who perform nipple-sparing mastectomies use smaller incisions placed in the breast fold at the bra line or near the areola’s border.
Either way, the incision is generally smaller and more hidden compared to the more traditional central incision that includes nipple-areola complex (NAC) removal. Furthermore, the amount of tissue and skin that surgeons remove during a traditional mastectomy may result in poorly-formed skin creases, making it more difficult for women to achieve cosmetically appealing reconstructed breasts. In addition to preserving and maintaining the appearance of their nipples and areolas, studies show that NSM does not increase the risk of breast cancer recurrence.
The main advantage of NSM is breast enhancement. Although plastic surgeons can perform nipple reconstruction procedures, the result does not produce the most natural appearance. NSM preserves the nipple, areola, and much of the woman’s skin, creating a beautiful breast with minimal scarring after surgery. These results also provide women a more positive image of their bodies post-cancer and improved self-esteem.
Drawbacks to Nipple-Sparing Mastectomy
There are no existing studies that show adverse health outcomes resulting from leaving the nipple and areola intact. However, some women note that their nipples are either permanently flattened or permanently erect. Some would prefer one over the other or struggle with decreased nipple sensation. Most women also have one breast that is 10-20% larger than the other. This means if we remove the glandular tissue, the well-matched reconstruction we place underneath may cause the nipples to heal in slightly different positions as a result.
Finding the Right Surgeon for Your Procedure
Nipple-sparing mastectomy is a complex procedure that can be highly challenging to perform in less experienced hands. When performed incorrectly, the surgeon may negatively impact the blood supply to the nipple or skin, causing the tissue to die. The rate of tissue necrosis should be under 5%. At our practice, it is under 1%.
Some surgeons may also deem the procedure unsafe, especially when they encounter higher than average rates of inadequate blood supply after surgery. In these cases, they may choose not to recommend the procedure.
In skilled and experienced hands, however, almost every patient can be considered for the sparing technique. A few exceptions include those who have had previous surgeries around the nipple, those with more severe cancer cases, or those with a breast that is so large that the central tissue should be removed to achieve a final size and shape best suited for them. Some patients elect not to have reconstruction at all for personal reasons. Some of these women may also undergo what is known as a Goldilocks Mastectomy (where the patient’s skin and tissue are used to create the new breast).
We also encourage patients to get a second opinion. If a doctor tells you that a nipple-sparing mastectomy procedure is unsafe or impossible to perform, ask more questions such as:
- Why is this impossible to perform?
- Have they ever tried to do a nipple-sparing mastectomy in this situation before?
- On what percentage of their patients do they generally offer and perform NSM?
- If the number is less than 80%, why is this the case?
- Are they willing to try?
In some cases, it may not be ideal to leave one or both nipples. However, it is easier for surgeons to perform surgeries using traditional techniques as the default procedure. Some surgeons aren’t eager to adapt to newer approaches because they may not see the intrinsic value of preserving the nipples. However, this extra step can make a woman look and feel as beautiful as possible at the end of her breast cancer journey.
Nipple-Sparing Mastectomy at Bedford Breast Center
At Bedford Breast Center in Los Angeles, CA, our goal is to cancel cancer, not beauty. Our medical center safely offers NSM as our surgeons are experts and highly trained in this procedure, and we always screen each patient carefully to make sure this is a safe option for them. We can perform NSM on about 95% of women whose breast cancer is not in the nipple.
As this breakthrough procedure grows in popularity, we strive to set a high standard for our patient outcomes. Our goal is to perform the best work we can at all times and raise the bar for both ourselves and others. We hope that patients everywhere will demand nipple-sparing mastectomy whenever it is a safe option. Our techniques offer lower complication rates and the best aesthetic results. Our specialized team of plastic surgeons can also perform one-stage breast reconstructions, giving patients natural-looking breasts during the same operation as the mastectomy.
Bedford Breast Center was created to provide state-of-the-art, individually tailored patient care in a warm, supportive environment. We will partner with you to achieve the best outcomes, both medically and aesthetically.
Schedule a Consultation at Our Medical Center Today
We know that you have questions and concerns about your mastectomy journey. We recommend having a consultation with a breast specialist to explore all your available options and make the best surgical decision for you. For more information or to schedule an appointment, contact us online or call (310) 278-8590.
This post was originally published in 2021 and has been updated.